Howie P W, Forsyth J S, Ogston S A, Clark A, Florey C D
Ninewells Hospital and Medical School, Dundee.
BMJ. 1990 Jan 6;300(6716):11-6. doi: 10.1136/bmj.300.6716.11.
To assess the relations between breast feeding and infant illness in the first two years of life with particular reference to gastrointestinal disease.
Prospective observational study of mothers and babies followed up for 24 months after birth.
Community setting in Dundee.
750 pairs of mothers and infants, 76 of whom were excluded because the babies were preterm (less than 38 weeks), low birth weight (less than 2500 g), or treated in special care for more than 48 hours. Of the remaining cohort of 674, 618 were followed up for two years.
Detailed observations of infant feeding and illness were made at two weeks, and one, two, three, four, five, six, nine, 12, 15, 18, 21, and 24 months by health visitors.
The prevalence of gastrointestinal disease in infants during follow up.
After confounding variables were corrected for babies who were breast fed for 13 weeks or more (227) had significantly less gastrointestinal illness than those who were bottle fed from birth (267) at ages 0-13 weeks (p less than 0.01; 95% confidence interval for reduction in incidence 6.6% to 16.8%), 14-26 weeks (p less than 0.01), 27-39 weeks (p less than 0.05), and 40-52 weeks (p less than 0.05). This reduction in illness was found whether or not supplements were introduced before 13 weeks, was maintained beyond the period of breast feeding itself, and was accompanied by a reduction in the rate of hospital admission. By contrast, babies who were breast fed for less than 13 weeks (180) had rates of gastrointestinal illness similar to those observed in bottle fed babies. Smaller reductions in the rates of respiratory illness were observed at ages 0-13 and 40-52 weeks (p less than 0.05) in babies who were breast fed for more than 13 weeks. There was no consistent protective effect of breast feeding against ear, eye, mouth, or skin infections, infantile colic, eczema, or nappy rash.
Breast feeding during the first 13 weeks of life confers protection against gastrointestinal illness that persists beyond the period of breast feeding itself.
评估母乳喂养与婴儿出生后头两年疾病之间的关系，尤其关注胃肠道疾病。
对母亲和婴儿进行前瞻性观察研究，出生后随访24个月。
邓迪的社区环境。
750对母婴，其中76对被排除，原因是婴儿早产（小于38周）、低出生体重（小于2500克）或在特殊护理中接受治疗超过48小时。在其余674对的队列中，618对随访了两年。
健康访视员在婴儿两周、1个月、2个月、3个月、4个月、5个月、6个月、9个月、12个月、15个月、18个月、21个月和24个月时对婴儿喂养和疾病进行详细观察。
随访期间婴儿胃肠道疾病的患病率。
在校正混杂变量后，母乳喂养13周或更长时间的婴儿（227名）在0至13周（p<0.01；发病率降低的95%置信区间为6.6%至16.8%）、14至26周（p<0.01）、27至39周（p<0.05）和40至52周（p<0.05）时，胃肠道疾病明显少于从出生就人工喂养的婴儿（267名）。无论在13周前是否添加辅食，这种疾病减少情况均存在，且在母乳喂养期之后仍持续，同时住院率也降低。相比之下，母乳喂养少于13周的婴儿（180名）胃肠道疾病发生率与人工喂养婴儿相似。母乳喂养超过13周的婴儿在0至13周和40至52周时呼吸道疾病发生率有较小幅度降低（p<0.05）。母乳喂养对耳部、眼部、口腔或皮肤感染、婴儿腹绞痛、湿疹或尿布疹没有一致的保护作用。
出生后头13周进行母乳喂养可预防胃肠道疾病，且这种保护作用在母乳喂养期之后仍持续。
